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CHIROPRACTIC TECHNIQUE
TECHNIQUE CHIROPRACTIC
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Monika A. Buerger, DC
Chiropractic truly is a Science, Art and Philosophy. When you understand the science, philosophy becomes more solid. When philosophy becomes more solid, the science becomes even more meaningful. The two have reciprocal consequences that lead to an increased level of confidence and certainty in practice. This is the place where the art of chiropractic then manifests at the highest energetic level.
According to the Centers for Disease Control (CDC), the current rate of Autism Spectrum Disorder (ASD) in the United States is 1 in 44 children. In a paper released in September of 2021 in JAMA Pediatrics, researchers found that preemptive intervention for Autism Spectrum Disorder from age nine months among a sample of infants showing early signs of ASD led to reduced ASD symptom severity across early childhood and reduced the odds of an ASD diagnosis at age 3 years. So, what was this early intervention? The answer to this is the framework for the future of pediatric chiropractic from a neurodevelopmental perspective.
I believe that in order to understand the answer to the above “early intervention”, we should first have some basic understanding of what is known from the current chiropractic neuroscience literature. Studies done by top researchers, Heidi Haavik and her team, have repeatedly shown that adjusting the spine will influence the way that the Prefrontal Cortex (PFC) processes somatosensory information. Among a host of critical functions, the PFC is considered the “Executive Functioning System” of the brain; it also controls our social engagement system. In the above noted study, the preemptive intervention given to reduce the odds of a later ASD diagnosis was that of coaching caregivers on appropriate social engagement interactions with their children.
The future of neurodevelopmentally based pediatric chiropractic care is being able to look at what I call the NeuroMatrix and understanding WHEN during development did the insults occur, WHAT those particular insults may have been and WHERE did the insults potentially leave their mark on the developing nervous system. Proper social engagement with caregivers is essential for bonding. It is well known that caregiver bonding with newborns is important in order to establish a healthy relationship between the child and their caregivers. Bonding is also necessary to foster healthy relationships and emotional regulation throughout one's life. However, this life altering process is also important in neurological development. Social engagement with caregivers, especially with mom, in the form of eye contact and infantile directed speech, has shown activation within the Medial Prefrontal Cortex (mPFC). Evidence suggests that the mPFC exhibits functional activation much earlier than previously thought, suggesting that the mPFC is involved in social information processing from early in
life. The mPFC is also known to be important for human social cognition and behavior throughout life. Social engagement, particularly with mom, produces the important hormone He who knows things from their beginning oxytocin; also known as the "love drug" oxytocin helps us relate to others and strengthens trust and closeness in and origins understands relationships. Oxytocin also activates them better … the vagus nerve which is the prime driving force of the parasympathetic -Aristotle , 4th century BC nervous system and is responsible for the anti-inflammatory arm of immune system modulation, gastrointestinal regulation, heart rate and a host of other critical neurophysiological responses; all of which are known to be dysfunctional in those with neurodevelopmental disorders. In the world of neurodevelopment and neuropsychiatry, the maturation of the autonomic nervous system, of which the PFC will be the primary regulator, is considered the neurobiology of physical, mental and emotional disease. I see the future of pediatric chiropractic and neurodevelopment intertwined and working alongside (actually leading) those in other professions that understand that regulation of the autonomic nervous system and processing information from our world is the key to health and development. If the chiropractic adjustment helps to modulate processing of sensory information in the PFC, it stands to reason that it may also play a role in the development of proper social engagement and caregiver bonding. Therefore, getting children under chiropractic care from the beginning of life could potentially steer the course of neurodevelopment and turn the tide on a later diagnosis of autism or other neurodevelopmental disorders. Understanding the profound effect that chiropractic care can have on the entire life of a child is one of the most amazing and inspirational things that this profession has to offer!
TORQUE RELEASE TECHNIQUE® : A VISION OF THE FUTURE
Jay M. Holder, DC, DACACD, FICA Aaron M. Holder, DC, DACACD
Torque Release Technique® (TRT) debuted on campus at Life College in 1995, the first technique of chiropractic’s second century. TRT’s mission has always maintained that the singular purpose of adjusting the subluxation is Salutogenic. TRT does not treat a condition, disease or symptom; it only proposes that in adjusting a subluxation we can improve the patient’s state of wellbeing and human potential.
TRT is a technique but most important is its technique model. TRT is the only non-linear, vitalistic and tonal model existing in chiropractic today. There are several key issues that make up this model of which we will only list a few. First there is our differential diagnosis of ruling out the many secondary and tertiary subluxations to determine the primary subluxation. One of TRT's methods to perform this is our functional leg length reflex (FLLR), which is an Achilles deep tendon reflex performed in the prone position, where we are not concerned about leg length or making the legs even. Rather it is an objective neurological exam that rules out secondary and tertiary subluxations and objectively identifies the primary subluxation.
Another is to recognize and understand that the subluxation is not the bone, but the bone subluxates. The subluxation is a neurological projection in three-dimensional space in an X, Y and Z axis, known as the listing. Adjustments are made with the Integrator® which is the only instrument that reproduces all of the corrections and three dimensional motions including torque that the hands perform to produce a toggle recoil adjustment that fires independent of the practitioner. It is the first chiropractic instrument to be registered and indicated for the adjustment of the vertebral subluxation by the U.S. government.
It is our position that all techniques work, but it is the art of the practice of the individual chiropractor that makes that possible, not the technique itself. TRT is the only technique to be created out of a randomized clinical trial which was published by the prestigious journal Nature. All other techniques have been created by mind’s eye with their research after the fact and are based on a linear, mechanistic Newtonian model which is why all first century techniques are not allowed to change. This additional difference allows TRT to constantly change and upgrade itself several times a year based on the constant flow of incoming research from many fields worldwide.
This allows us to set the stage in understanding what the future will look like for TRT. TRT will provide a holographic theater platform during adjustments which will automatically download into the medical record and validate adjustment intervention. Eventually the FLLR mentioned above will be replaced and upgraded by table mounted digital sensors that will record and identify our FLLR neurological leg check and automatically download the findings in the medical record. The future Integrator® will be digitized and be able to provide advanced harmonic frequency cloaking which will match the primary subluxation's HZ frequency to provide a more sustainable adjustment.
This will also allow for each adjustment to retrace multiple layers at a time instead of today's retracing only one layer at a time. Vortex safety sensors in the Integrator® will guarantee and confirm the exact alignment of the required lines of drive in the X, Y and Z axis of the listing including its superior or inferior lines of drive also known as the torque, prior to allowing the Integrator® to adjust.
Even the method in the teaching and training of TRT will be strikingly different in the future. TRT's training and teaching will come into the home or office of the chiropractor in the form of a holographic platform, which will provide instantaneous corrections to any mistakes made by the chiropractor during training. This will allow chiropractors to attain maximum and intraprofessional reproducibility and proficiency in performing TRT in the clinical setting, without having to attend a seminar or learn about a hands-on technique online.
In 1986 Dr. Larry Webster formed the International Chiropractic Pediatric Association (ICPA) with a simple mission: all children deserve chiropractic care. Then, like now, it was apparent that children were in desperate need of chiropractic care and its intrinsic benefit to the central nervous system. Tragically, exposure to a myriad environmental, emotional and physical stressors has been on the rise. It was no less than visionary to recognize that the future of health was in supporting the spine and nervous system as early as possible rather than allowing the dysfunctional neurological patterns to develop and persist.
This message was no doubt inspiring for many chiropractors drawn intuitively to the care of babies and children. One such inspired chiropractor was my mother, Dr. Jeanne Ohm, who first became involved with the ICPA after taking a class with Dr. Webster in 1995. Already seeing many families in practice, it was a twist of fate and a drive to better serve her community that drew her to take these classes and after being exposed to Dr. Joe Felicia’s class on birth trauma, a fire was lit inside her.
If, when caring for a child’s spine and nervous system, earlier is better, then supporting the mother during pregnancy and thereby minimizing the initial trauma to the baby is best. After Dr. Webster’s untimely passing in 1997, my mother became more involved in the ICPA, developing the Webster Technique into a certification in 2000 and eventually taking on the role of executive director in 2002. Since then, more than 10,000 chiropractors have been trained in the Webster Technique impacting a truly remarkable number of births and therefore babies around the world.
The fulfillment of chiropractic is in taking care of the family as a whole. Over the past decade, the relevance of a salutogenic rather than reactive or pathogenic approach to health
has become apparent. My mom, and by extension the greater ICPA membership, have called this focus “the chiropractic family lifestyle.” Those of us who focus on family care in practice know that families who seek out regular chiropractic care have a unique and powerful trust in their body’s ability to express life. It is subtle at first, a curiosity that brings them into the office, but like a seed in rich garden soil, it grows into a lasting confidence that supports the journey of that family.
With confidence comes resilience. More and more families are discovering the supportive role that chiropractic care provides for them. A focused model of care that is directed towards functional improvements rather than symptomatic abatement and perhaps most importantly, that respects and honors the body’s own innate capacity to heal and regenerate, is a powerful and liberating perspective to embody. The family chiropractor is in a unique and privileged role to deliver this perspective. This is so vital in a world seemingly paralyzed by fear.
Chiropractors have always possessed a radical, innate perspective, and I feel this is not about to change, nor should it. In fact, what we need now, more than ever, is for chiropractors to step up in their communities and serve the many families that are choosing a more proactive trusting direction for their health and function. Chiropractic care at its very core has always been focused on the function of the nervous
system and the powerful effect it has on all aspects of wellbeing. We would be wise to recognize the importance of this focus. In his last printed words, BJ Palmer said: “May your innate receive and act on that free flow of Wisdom from above-down, inside-out… for you have in your possession a Sacred Trust. Guard it well.”
We must stand for the families in our communities and offer to them the understanding of the chiropractic family lifestyle, trust in the power of healing, awareness of our innate potential, nurturing the realization of health, and confident in the wisdom of “life expresses intelligence.” We are in fact the ones they have been waiting for. The nervous system is the key; chiropractors care for the nervous system; all children and pregnant women and families deserve chiropractic care. We must not forget that.
THE FULFILLMENT OF FAMILY CHIROPRACTIC CARE
Justin Ohm, DC
Deed E. Harrison, DC
CBP (Chiropractic Biophysics) patient management protocol involves all typical initial patient examination procedures including the consultation, examination and pain, disability and quality of life questionnaires. In addition, CBP treatment consideration requires, without exception, a fullspine posture assessment as well as full-spine AP and lateral standing spinal radiographs. Posture needs to be quantitatively assessed as rotations and translations of the head, thorax and pelvis in three-dimensions. The x-rays need to be digitized and quantified, using the Harrison posterior tangent method for the sagittal images and with the modified Risser-Ferguson on the AP images.
CBP structural rehabilitation is suggested as either 3 times per week for 12 weeks (36 treatments) or 4 times per week for 9 weeks (36 treatments). However, the CBP published controlled trial data support treatment blocks of 30-40 treatment sessions over the course of 9-12 weeks. An initial patient who has acute or chronic pains and who has not been treated recently or at all for their current spine issue should be seen for an initial 6-12 treatments to provide pain relief. After signs of relief have occurred, a progress exam should be performed and the patient should be transitioned or ‘graduated’ to CBP corrective care interventions.
CBP treatment occurs in ‘blocks of care.’ Numerous CBP controlled clinical trials provide evidence for spine altering changes to occur in the range of 30-40 treatment sessions. The end of each block of CBP care requires a progress exam which includes all of the typical assessment procedures as well as a posture and x-ray assessment. Exam results may either dictate the need for further CBP treatment or the recommendation for ‘supportive’ or maintenance care. An initial block of CBP structural rehabilitation will include any acute care provided in the first 2-4 weeks.
While the CBP published research data does not specifically support 6-12 month care plans, based on the available data, an adult typically needs 6 months of corrective care (e.g. 72 treatments over 6 months at 3x/week) which is an evidence-based recommendation based on results from randomized trials. Although, any given patient may require a shortened (i.e. 1-2 months) or longer treatment programs (6-12 months) based on their initial presenting postural, spinal, and pain and disability parameters. There is also support for supportive/ maintenance care at a frequency of approximately 1-2x/month. CBP technique has an abundance of clinical evidence supporting its effectiveness in correcting spine deformity and abnormal posture. Recently, systematic reviews have summarized the clinical evidence as reported in the published controlled trials on these methods for the cervical and lumbar regions.
CBP technique interventions are known to improve patients’ pain, disability, quality of life, and neurophysiological measures in those suffering and presenting with abnormal spine and posture structural deformities (subluxations). Due to the scientific credibility of CBP’s 240 (plus) peer-reviewed publications, the International Chiropractor’s Association (ICA) has awarded CBP Technique with a professional Diplomate Program - the new 420 hour CBP Diplomate led by Dr. Deed Harrison (see www.IdealSpine.com for details). Due to the economic and health benefits of CBP Technique methods and the global burden of spine disorders, CBP technique should continue to grow in the chiropractic, physical medicine, and general rehabilitation settings for spine disorders and for patient health and well-being. CBP will continue to publish high quality research and develop better patient intervention strategies. As such, it should rightly take its place as a leading patient rehabilitation approach for the correction of spine and posture abnormalities in Chiropractic Education and Technique.
